The Views of Family Members about Nursing Care of Psychiatric Patients Admitted at a Mental Hospital in Malawi

Family members of a mentally ill person play a crucial role in the recovery of their sick relative. They care for their sick relatives at home and in hospital. Some views of family members indicate that they get satisfaction from participating in nursing care of their sick relative. The aim of this study was to describe the views of family members about nursing care of psychiatric patients admitted at a mental hospital in Malawi. A qualitative study design was used and data were collected from ten participants through in-depth interviews. Ethical approval was granted by relevant authorities. Data were analysed using Colaizzi method. The findings fell into the following four themes that emerged: family participation in nursing care;nurses’ skills and experience in caring;respect for psychiatric patients and interactions and information sharing. This study offers valuable information about the views of families regarding nursing care of psychiatric patients. They are involved in the care of their sick relatives although there is lack of effective cooperation between them and nurses. The lack of collaboration made families receive inadequate information about their sick relative. Therefore, it is imperative that nurses are competent in implementing family involvement in nursing care.

Classroom-Based Parent Interview in Psychiatric Mental Health Nursing

A classroom-based parent interview was designed and implemented in an undergraduate psychiatric mental health nursing class to fill the gap between nursing students and parents of child or adolescent patients with mental health issues faced during clinical. The goals of this learning activity were to increase understanding of what parents experience when dealing with their child’s mental health problems and to increase student engagement and attention. The class using this learning activity consisted of three parts: 1) an assigned pre-class reading;2) a mini-lecture;and 3) a parent interview presentation. Students were pre-assigned a reading chapter and faculty-developed interview questions. During the mini-lecture, important knowledge related to mental health care of children was assessed using CourseKey software. After the mini-lecture, the parent guest speaker delivered her presentation about herself, her child’s strengths and abilities, her child’s mental health problems and their impact, and her family’s strengths based on the interview question prompts for about 30 minutes, followed by 20 minutes of a Q & A session. The set of interview questions was developed by faculty based on the competency questions of the Child Behavior Check List. Despite some limitations, this classroom-based parent interview using a flipped classroom model was found to be a meaningful learning strategy by increasing student engagement and attention, increasing retention of knowledge learned in class, and filling that gap in clinical.

Physical restraint using,autonomy,ethics among psychiatric patients in nursing practice in China

The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all(clients and staff)while at the same time curtailing the individual’s autonomy.This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy,beneficence,nonmaleficence,and ethical theories.Given that nursing workforce was limited and workload among psychiatric nurses was heavy,physical restraint was one of the coercive interventions managing aggressive behavior.In relation to address ethical dilemmas,it was proposed to acquire informed consent of physical restraint from the individuals and provide person‑centered care.Effective communication and negotiation with patients could help to strike a balance between patients’autonomy and nurses’accountability when using physical restraint.In addition,guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint.Finally,a collaboration among nurses,psychiatrists,and families is essential to protect patients’autonomy concerning physical restraint use.

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©)

The purpose of this study was to develop the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©. This study used the on-line survey method from February to April 2015. There were 644 respondents comprised of professional nurses with minimum qualification of 3 years’ experience being in a psychiatric unit of a stand-alone 200-bed or more Psychiatric Hospital in Japan. Assessment items were derived from 211 specific items selected from nursing textbooks, excluding the North-American-Nursing-Diagnosis-Association (NANDA). The questionnaire contained Cover Letter, Demographic Data Sheet, and the PsyNACS© questionnaire. There were 644 questionnaires accessed but only 435 were completed and valid. Item levels of importance were evaluated: 1) Unnecessary, 2) Not very important, 3) Important and 4) Very important. Data analysis used descriptive and multivariate statistics. Factor analysis (principal factor analysis, varimax rotation), the Kaiser-Meyer-Olkin (KMO) and the Bartlett’s test of Sphericity assessed the adaptive validity of the factor analysis. Factor loadings were set at 0.4 or more for the configuration of items. Internal consistency and reliability were established using Cronbach’s alpha coefficient. Mean factor points were calculated, including standard deviation, range, and confidence interval at 95%. Statistical significance was at 0.05 level. Nine Patient Assessment Data (PAD) with 2 to 5 Cluster Assessment Data (CAD) each were categorized. Thirty one CADs comprised the Patient Assessment Data: (PAD1) Psychological symptom and stress, (PAD2) Information about treatment, (PAD3) Function of eating and balance of water, (PAD4) Life and value, (PAD5) Vital signs and health assessment, (PAD6) Self-care, (PAD7) Social support, (PAD8) Activity, sleeping and mobility capability, and (PAD9) Sexual function and sexual behavior. The PsyNACS© is a classification of items assessing health care needs within the Japanese psychiatric nursing care environment, and also can be used in various psychiatric patient care situations in all psychiatric units.

Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©

The study identified priorities of the Patient Assessment Data (PAD) using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©) derived from 644 psychiatric nurses’ responses who were practicing in specific units: Acute Care Units (ACU), General Care Units (GCU), Long-term Care Units (LCU), physically Complicated Disease Care Units (CDCU), and Dementia Care Units (DCU). Secondary analysis of the PsyNACS©on-line survey data using four levels of “importance” was used to determine the priorities: 1) unnecessary;2) quite important;3) important and 4) very important. The Mean Factor Points (MFP) and the Welch’s ANOVA were calculated. PsyNACS©score of 3 or higher indicates the PAD as priority. The results showed that in the ACU PAD1, “Psychological symptom”, “Stress coping”, and “Mood disorder and aggression”, and PAD2 “Information of adherence”, and “Information of the psychiatry rehabilitation”, and PAD7 “Situation of the family and social life”, “Relationship to the health care providers”, and “Relationships with others” are high priority (high importance). Other PADs showed results below PsyNACS©score of 3. The GCU had PAD 3 “Balance of water”, the LCU had PAD 4 “Intention/Point of view”, and “Thoughts of the patient” and PAD 7 “Disease and family”. The CDCU showed PAD 2 “Blood test”, PAD 3 “Excretion situation”, and PAD 5 “General health condition”, “Respiratory and chest symptom”, and “Vital signs”, and the DCU had PAD 1 “Cognition function”, and “Delirium and derangement capacity to register failure”, PAD 3 “Function of eating”, PAD 6 “Egestion and cleanliness” and PAD 8 “Activity and sleeping”, and “Mobility capability”. These classifications indicated levels of importance in the CAD comprising the PAD below the score of “2”. Japanese psychiatric hospitals specify assessments according to functional areas. By prioritizing the CAD for each PAD, more effective and efficient assessments can be performed according to practice unit.

Criteria for Determining the Need for Admission of People with Dementia to Dementia Nursing Wards of Psychiatric Hospitals in Japan

Purpose: This study aims to establish criteria to determine the need for admission of people with dementia to dementia nursing wards of psychiatric hospitals—based on the experience of nurses working in dementia nursing wards. Methods: Semi-structured interviews were conducted with nurses who had worked in dementia nursing wards of psychiatric hospitals for more than 3 years, to collect data related to the “condition at the time of admission and the process of hospitalization of dementia patients”. Data were analyzed using the content analysis approach. Focusing on “What is the condition of patients with dementia admitted to the dementia nursing ward?”, we created codes according to similarities in the meaning, and classified these into categories where they were evaluated to fully fit in. Results and Discussion: The analysis yielded 4 categories, and 44 codes. The four categories are as follows: [Appearance of a state where self-control is difficult] which expresses a state where behavioral and psychological symptoms of dementia (BPSD) have appeared, and the remaining three categories [Insufficient support provided], [Appearance of symptoms that make living difficult], and [Appearance of physical symptoms that require treatment] express the states that may trigger the appearance of BPSD. These show that the appearance of BPSD is a criterion for determining hospitalization. By providing support to prevent the states described in the 44 codes, nurses may help people with dementia avoid being hospitalized in dementia nursing wards in psychiatric hospitals.

The Correlation between Psychological Resilience and Professional Quality of Life in Saudi Psychiatric Nurses:A Cross-Sectional Study

In recent years,significant focus has been placed on resilience,with ongoing studies aiming to identify strategies for reducing the negative effects of job stress and protecting nurses from negative psychosocial outcomes.Nevertheless,as far as this topic is concerned,no research has yet been conducted in the context of Saudi psychiatric nurses.The aim of this research,therefore,is to determine how Saudi Arabian psychiatric nurses’professional quality of life and psychological resilience relate to one another.To this aim,a cross-sectional study has been performed in Saudi Arabia incorporating a population of 167(a 66.4%response rate)mental health nurses taken from the largest psychiatric hospital in the capital city Riyadh.Data collection was performed using the popular Arabic version of the Connor–Davidson Resilience and the Arabic version of the Professional Quality of Life Scales.To assess the variables related to both Professional Quality of Life and psychological resilience levels,statistical analyses such as Pearson correlation,ANOVA,t-tests,and linear regression were utilized.The findings show compassion satisfaction and burnout to have a moderate inverse relationship(r=−0.502),while compassion satisfaction(CS)and resilience have a moderate positive correlation(r=0.594).Compared to their morning-shift counterparts,nurses working night shifts reported higher mean scores for resilience(72.70),CS(40.20),burnout(24.52),and compassion fatigue(CF)(28.11).Participants with less than five years’experience in a psychiatric clinic had the highest mean resilience score(72.96).Finally,a positive relationship between resilience and compassion satisfaction(CS)was revealed using linear regression analysis(β=0.536,t=7.080,p=0.000).The study reveals significant differences in the scores assigned to resilience and work-life quality based on educational qualifications,shift-work type,and experiences.Burnout and compassion satisfaction(CS)are found to be significantly correlated,as are compassion satisfaction(CS)and resilience,and burnout and compassion fatigue(CF).

A Survey of Correlation between Professional Identity and Clinical Competency of Psychiatric Nurses

Introduction: Clinical competency and knowledge of the effective factors are of critical importance in nursing. Competency, self-esteem, and self-knowledge are achievable through professional identity. Employees’ participation in and attachment to their professional role is contingent considerably upon their professional identity. In light of this, the present study is aimed at determining correlation between professional identity and clinical competence of the nurses working in psychiatric wards of the hospitals affiliated with Tehran-based medical sciences universities. Methodology: This correlative study was conducted on 125 nurses working in psychiatric wards of Tehran-based hospitals affiliated with medical sciences universities. Data gathering tool of the study was a researcher-designed questionnaire to collect demographic, clinical competency, and professional identity data of the participants. For data analyzing, Statistical Package for the Social Sciences (SPSS) version 18 was used. Findings: The results showed 91.2% of the participants evaluated their professional identity at good (47.2%) and very good (44%) levels;and 78.2% evaluated their clinical competency at very good level. The results also indicated positive and significant relationship between professional identity and clinical competency(r = 0.32, p = 0.001). In addition, none of the demographical variables were related to professional identity and clinical competency. Conclusion: There is positive relationship between clinical competency and professional identity, which means that development of positive attitudes regarding the psychiatric nursing can lead to higher clinical competency of the participants. The findings of the study highlighted the weight and role of positive attitude regarding the professional identity. It could result in increase of clinical competency and deserved attention of hospital’s managers.

Occupational Stress, Coping Strategies, and Quality of Life among Nurses in General and Psychiatric Setting in Jeddah City—KSA

Purpose: This study is aimed at comparing the level of occupational stress, ways of coping and the quality of life among nurses. Methods: Descriptive explanatory design was used with 278 nurses working in King Abdul Aziz Hospital in Jeddah, Mental Health Hospital in Jeddah, and Dr. Suleiman Fakeeh Hospital in Jeddah. Findings: Psychiatric nurses experience greater occupational stress than general nurses (p = 0.001). There was no statistically significant difference between the psychiatric and general nurses in relation to coping strategies (p = 0.38). Conclusion: Healthcare institutions should adapt stress evaluation and coping models specific to their unit. Practical Implication: Implementation of programs in each healthcare unit to educate nurses how to deal with work stressors and their negative effects.

Clarifying the Strengths-Oriented Attitude among Nurses in Psychiatric Hospitals in Japan

Japanese psychiatric mental health systems are being steadily improved. Psychiatric nurses’ attitude towards strengths of persons with mental disability is critical in order to promote de-institutionalization of patients. However, nurses’ attitudes, particularly their Strengths-Oriented Attitude (SOA) has not been well studied and explained. The purpose of this study was to clarify the SOA of nurses working in psychiatric hospitals in Japan. There were 1148 Psychiatric Registered Nurses (PRN) and Psychiatric Practical Nurses (PPN) employed at 17 psychiatric hospitals in Japan who consented to participate in the study. The self-administered questionnaire was mailed and returned between October 2013 and January 2014. The subjects’ SOA was evaluated using the Strengths-Oriented Attitude Inventory (SOAI) developed by the authors based on the work by Rapp and Goscha. The actual SOA and its relationship to individual characteristics were also analyzed to clarify the SOAI. Factor analysis revealed four components of the SOAI: Factor 1 = “Nursing practice based on the assessment which focused on social resources”;Factor 2 = “Nursing practice based on the holistic assessment of person with mental disability”;Factor 3 = “Support in community which respected the person’s way of living”;and Factor 4 = “Emphasize of the strengths of individual with mental disability.” Results indicated a high orientation toward Factors 2 and 4, but a low orientation toward Factors 1 and 3. There were no significant differences between age, years of psychiatric nursing experience, academic background, and subjects’ SOA. However, differences were observed in gender, current workplace, work position, type of license, and work experience. The subjects showed low orientation toward social resources and respected the patient’s way of life. Nurses working in psychiatric mental health institutions should receive continuing education courses designed to increase their orientation toward Factors 1 and 3.

Nurses Perception towards Determinants of Turnover in Psychiatric and General Hospital, Makkah Province

Background: Nurses leaving the profession are of concern to the government. This turnover can take the form of leakage and waste of both human and financial resources for governments that spend money on training nurses. Little is known about the intention to stay or determinants of job satisfaction among nurses in the Makkah region of Saudi Arabia. Aims: The study explores the determinants of intention to stay, job satisfaction, organizational commitment and self-efficacy among nurses. Methods: A cross-sectional study was designed, with a total of 175 nurses in the period between March 2017-July 2017. Results: No statistically significant differences were identified in intention to stay, job satisfaction, organizational commitment and self-efficacy between the psychiatric and the general nurses. A significant correlation was found between nationality, education and income, and intention to stay, job satisfaction, organization commitment and self-efficacy (p Conclusions: The study added various determinants of nurse turnover to the existing body of knowledge, relating to the factors concerning intention to stay, job satisfaction, organizational commitment and self-efficacy amongst general and psychiatric nurses.

Relationship between Level of Knowledge on Anger Control and Occurrence of Real Assaultive Behaviour in Patients (20 - 45 Years) Admitted at a National Referral Psychiatric Hospital in Zimbabwe

Background: Aggressive tendencies from psychiatric inpatients are increasingly becoming problematic at a national referral psychiatric hospital in Zimbabwe. No research has been done in this context to determine the dynamics around this disturbing phenomenon. Objectives: To determine the level of knowledge on anger control, to determine the occurrence of real assaultive behaviour and to examine the relationship between level of knowledge on anger control and occurrence of real assaultive behaviour in patients aged 20 - 45 years admitted at a national referral psychiatric hospital in Zimbabwe. Method: A descriptive correlational design was used. Seventy-six respondents aged between 20 and 45 years were selected using simple random sampling. A structured interview was used to collect data. The occurrence of real assaultive behaviour was adapted from the Staff Observation and Aggression Scale completed by observing patients during the assaultive behaviour occurrence. Patient observation was done by the psychiatric trained nurses who were specifically trained for this study to fill the part of the data collection instrument that needed observation. Data were analysed using descriptive statistics, Pearson Correlation Coefficient test and simple regression analysis. Results: Results showed a Pearson coefficient test of (r = -3.47, p Conclusions: Results call for collaboration of mental health practitioners to empower patients with anger control skills.

Changes in psychiatric nurse attitudes towards legal representation of inpatients at District Psychiatric Board hearings in Israel: a pilot study

Aims: To compare the initial attitudes of nurses and other professional groups in a psychiatric hospital towards the legal representation (LR) of involuntary admitted psychiatric patients before District Psychiatric Boards (DPB), and to assess how these attitudes changed after LR had become an everyday routine practice in the hospital. Background: LR of hospitalized psychiatric patients before DPB has been introduced into mental health system worldwide, including Israel. Attitudes of psychiatric staff towards LR and their changes over time are a very important –though unstudied issue. Methods: Thirty seven psychiatric nurses employed in the Tirat Carmel Mental Health Center, Israel and 30 other mental health professionals (comparison group) completed the Attitudes to Legal Representation Questionnaire before LR has been instituted in the Center (November 1, 2006) and one year later. Baseline differences between the groups were tested using one-way ANOVA, and prepost differences in the attitude scores were tested by paired t-tests. Results: Baseline psychiatric nurses attitudes towards LR were significantly more negative than those of the comparison group [F67,3 = 6.87, p 37 = 2.56, p = 0.015). Conclusion: Yearlong, routine exposure to the LR of involuntarily admitted psychiatric patients may attenuate negative nurse beliefs and attitudes towards LR of such patients at DPB hearings. The more positive attitudes may enhance the nurses’ ability to present information about patients without jeopardizing their human and civil rights, and help patients to attain a greater sense of control over their illness management and satisfaction with the services received.

Examination of Three Case Studies of Caring for Psychiatric Patients on a Medical Surgical Unit

Medical surgical nurses frequently care for patients with psychiatric disorders as one in four people have a diagnosed psychiatric disorder. Since these nurses specialize in medical surgical nursing, they often feel they lack the expertise to care for patients with co-morbid psychiatric problems. This article presents three case studies and delineates nursing care strategies which could assist the medical-surgical nurses in caring for this population.

The nurses’ voice of working in a newly established community based 24-hour support center for people with psychiatric disabilities

This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.

Violence Prevention in a Psychiatric Unit

Psychiatric units are one of the most frequent settings of violence against medical staff. This affects the physical, emotional and psychological well-being of the staff and has an impact on their quality of care and the interactions with patients inside the unit. Evaluate if SDAS scores at admission in an inpatient psychiatric unit can be predictive of violence and aggression among admitted patients towards medical staff. Charts of all patients admitted during a 12 month period were retrospectively reviewed and their SDAS scores at admission registered, and all violent events reported by nurses during the same period were collected. SDAS scores significantly contributed to the prediction of the violent behavior against nurses, non dependent on psychiatric diagnosis at admission. SDAS can represent a tool that can help psychiatric nurses identify patients at risk of violence and therefore improve management of these patients.

体验式教学在精神科护理实习生临床教学中的应用

目的探讨体验式教学在精神科护理实习生临床教学中的应用效果。方法将220名护理实习生按照随机数字表法分为研究组和对照组,各110例。对照组护理实习生给予常规的培训教学模式,研究组护理实习生给予体验式教学模式。临床教学结束后,比较两组护理实习生课程评价问卷(CVI)评分、人文关怀能力量表(CAI)评分和临床综合护理能力考核成绩及成绩优良率。结果临床教学结束后,研究组护理实习生CVI总分及各维度评分、CAI总分及各维度评分、临床综合护理能力考核成绩及成绩优良率均高于对照组(P<0.05或0.01)。结论在精神科护理实习生临床教学中,采用体验式教学模式效果好,更符合素质教育以及科室岗位需求。

Caring psychiatric patients and its impact on nurses’behavior:a cross-sectional quantitative method study in Saudi Arabia

Objective:The present study aimed to address the care of psychiatric patients and its impact on nurses’behavior in Saudi Arabia.Methods:A cross-sectional quantitative questionnaire-based study was conducted.This study was carried out in various government hospitals across different regions of Saudi Arabia.Results:A total of 73 nurses participated in the study,with male nurses comprising the majority(61.6%)compared to females.Being a young nurse or with few years of work experience is linked with more predilection towards preventive behaviour and/or physical activity.A significant mean difference was observed,indicating higher scores for preventive behavior among females(female 14.93±5.82 vs.male 11.56±5.48,P=0.015).The Bonferroni post hoc multiple comparisons did not reveal any statistical significance for single vs.married(P=0.618),single vs.divorced(P=0.223),and married vs.divorced(P=0.020).Conclusion:The study results demonstrated a significant impact of caring for psychiatric patients on nurses’behavior.This is concerning because psychological and mental health strain has been shown to contribute to unhealthy lifestyle habits,such as physical inactivity and sleep deprivation,which,in turn,can contribute to the increasing incidence and prevalence of chronic diseases.Healthcare interventions targeting psychiatric and mental health nurses should be designed and examined to emphasize the importance of healthy lifestyle choices and an active lifestyle.

Reliability Verification and Practical Effectiveness Evaluation of the Nursing Administration Analysis Formulae Based on PSYCHOMS^(■)

In psychiatric hospitals, the ratios between patients versus physician and patients versus nurse are low as compared to those in general hospitals. Furthermore, usages of electronic medical records are also low so that nurse administrators are limited in their ability to compile, analyze, and generate patient care staffing information for their administrative use. Psychiatric nurse administrators anticipate the development of a nursing administration analysis system that could perform personnel data simulation, manage information on nursing staff, and manage ward/ practice operations. Responding to this situation, the authors developed a nursing administration analysis system utilizing formulae from the Psychiatric Outcome Management System, PSYCHOMS&reg;to aid nurse administrators. Such formulae are awaiting patent approval. The purpose of this study was to examine the validity of the formulae and the Structured Query Language (SQL) statement, and its practical effectiveness of analyzing data. The study findings showed that two kinds of computation expressions—a classification and extraction were able to display required information desired by nurse administrators. Moreover, significant information critical to assigning staff was validated to ensure high quality of nursing care according to the function and characteristic of the hospital ward.

The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person

This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.